The dissertation is devoted to improving the quality of treatment of patients with open fractures of the lumbar spine by implementing a new complex method of treatment. The topicality of this study was determined by the patients of the specified category.
Using a systematic analysis of roentgenological and clinical results of instrumental studies in patients with fractures of the LN of different localization by the classical method of osteosynthesis.
Retrospective analysis of 185 case histories of patients with a mandibular fracture who were treated at KMKL No. 12 of the ShHLV during 2016-2023. When patients were admitted, 51% were men, and 49% were women. Fractures of the angle and body of the lower jaw predominated in 55%, the mental department in 45%. A significant factor was dominated by transport 37%, household 27%, sports 26%, production 10%. The dynamics of received injuries in the aggregate of injuries of traumatic fractures of the lower jaw prevailed in 2017 and 2019 in terms of the number of received injuries.
Patients were divided according to the localization of the type of fracture of the LN, mental 45%, angle 55%, and the line passing through the tooth socket transversely 33%, obliquely 27%, tangential to the socket 40%. Having analyzed the nature of the treatment of patients with fractures of the lower jaw during the specified period, we found that osteosynthesis was performed in 59% of cases with a fracture of the lower jaw, and conservative treatment accounted for 41% of cases.
Of the 76 patients who were treated conservatively, 42 patients (55%) were accepted by us, and 34 patients (45%) were studied retrospectively.
Of the 109 patients of the retrospective analysis, clinically 70 patients (64%) were operated on by us using the classical method, and 39 patients were retrospectively processed (36%), this allowed us to determine the problems of the classical method of osteosynthesis with radiological measurement of diastasis in the fracture line before and after the operation and determination of bone density for the location of the plate (declaration patent of Ukraine for a utility model No. 150086). On the CT scan in the postoperative period, the presence of wound diastasis up to 2.4 mm was detected. in the mental department, in the body area up to 2 mm. At the stage of admission to the hospital, all patients underwent a clinical and X-ray examination, and if necessary, consultations of specialists in related specialties were prescribed. In the postoperative period, clinical observation of the course of wound healing was carried out. In the treated patients, control of fixation of the Tigerstedt splint was carried out conservatively. At the time of removal of the fixing devices, all patients showed signs of consolidation of bone fragments clinically and radiologically, even with wound diastasis of up to 2.5 mm, but occlusion disorders were detected in 12 patients. The teeth that were in the fracture gap were stable after endodontic treatment. The conducted retrospective analysis made it possible not only to determine the types of displacement of bone fragments with fractures of the body, mental part of the lower limb and to find the predominant localization of the fracture in the tooth-containing areas.
